CHAPTER FOUR: THE BUDDY SYSTEM OF RESTORATION FOR MOSTDIS

CHAPTER FOUR: THE BUDDY SYSTEM OF RESTORATION FOR MOSTDIS

COMPONENTS OF THE BUDDY SYSTEM OF IMPLANT DENTISTRY

MOSTDIBUD

BUD: Bridge Underpinning Device

The bud is basically a coping with an O- RING incorporated inside to give a positive repeatable precision placement onto the SDI. It is quite similar to the dental anchoring device (DAD) used with small dental implants. It consists of a housing with an O-Ring incorporated inside.

The BUD is shaped more like a tooth abutment. Larger than the DAD(Denture Anchoring Device), it is about 5mm in height. The MOSTDI is screwed down until only about 4 to 4.5mm is sticking out above the gum level. This results in a smooth metal interface with the mucosa immediately around the SDI. The bud can be cemented and trimmed to size or left as it is, if trimming is unnecessary. The impression is then taken and sent to the lab for crown and bridge construction.

If the bud is not cemented, it can be used to carry a temporary crown or bridge. This can be removed easily when a more permanent restoration is constructed. If a temporary cement is used to cement the BUD onto the abutment, the crown and bridge can be retrieved with a crown remover. Such a BUD can also be used as a DAD with the added advantage that if none of the SDIs are exposed, cold curing of the denture will not go into any undercuts. As such, after cold curing, the denture can be removed with a steady and sustained pull force on the denture. However, if any part of the SDI is exposed, it can be protected with one or more O-rings. The orthodontic elastic separators (O-rings) can be used.   

PICTURES

(1) MOSTDIDAD/ MOSTDIBUD

(2) BUD IN USE IN MOUTH

(3) BUD WITH BLUE O-RING

BONE CLIMBING UP DENTAL IMPLANT

 The lower right first molar was extracted due to severe periodontitis resulting in loss of bone support. Two mini dental implants were immediately inserted into whatever bone was available. The patient was covered with antibiotics for several days. A porcelain bonded to metal crown was fixed about 2 months later over a composite core that was lightcured over the minis. Six years later, an xray was taken.... looks like the bone has "climbed up" the implant. The tooth was firm and functional.
A NEW WAY TO REGAIN ALVEOLAR BONE SANS GRAFTS?!!

A SIGNIFICANT PARADIGM SHIFT IN THE GROWING BACK OF ALVEOLAR BONE

Human Histologic Verification of

Osseointegration of an Immediate

Implant Placed into a Fresh Extraction

Socket With Excessive Gap Distance

Without Primary Flap Closure, Graft, or

Membrane: A Case Report

Dennis P. Tarnow, DDS*

Stephen J. Chu, DMD ,MSD, CDT**

* Clinical Professor and Director of Implant Education, Columbia University College of

Dental Medicine, New York, New York.

** Clinical Associate Professor and Director of Esthetic Education, Columbia University

College of Dental Medicine, New York, New York.

This case report provides

clinical and histologic proof that the immediate placement of implants into

extraction sockets with an intact buccal wall allows healing and osseointegration

despite a large gap distance and without primary flap closure, a bone graft, or

a barrier membrane. (Int J Periodontics Restorative Dent 2011;31:515–521.)

In the discussion, the following statement was made:-

It is possible then that an

implant placed in an extraction site

without soft tissue closure could

heal with bone-to-implant contact

before the soft tissues have an opportunity

to interfere.

However, I beg to differ. 

Based on the case shared on "Bone Climbing Up Mini Dental Implant",

my postulation is as follows:-

In spite of the absence of a buccal and lingual plate, no well defined socket,

 a mini dental screwed into the cortical plate at the bottom of the bony crater

left behind by a mobile, periodontally compromised tooth, 

will stimulate the alveolar bone to reform and grow around the implant 

to a more normal level

 in spite of the presence of  granulation and epithelial tissue.

SINGAPORE ACADEMY OF MEDICINE GIVES MINIS THE NOD

SINGAPORE ACADEMY OF MEDICINE GIVES MINIS THE NOD

SINGAPORE ACADEMY OF MEDICINE GIVES MINIS THE NOD

ESPECIALLY FOR LOWER FULL DENTURE STABILIZATION

A LANDMARK DECISION AND ONE OF THE FIRST IN THE WORLD

BY A RESPECTED HEALTH AUTHORITY

1.    The Academy of Medicine Singapore with the Singapore Ministry of Health and other dental specialist bodies has recommended narrow diameter dental implants to be used for mandibular denture stabilization.

The recommendation comes with a high rating of Grade B, Level 2++. This rating means that it is recommended for use on patients and is supported by high quality systematic reviews of case control or cohort studies. Patients with implants between 2.5mm to 3.3mm for mandibular overdenture retention had good survival rates of more than 98% in two prospective studies.

2.    Below is the link to download the latest clinical guidelines for implant dentistry in Singapore:

http://www.ams.edu.sg/amsattachments/Dental%20implant%20CPG%20Booklet_revised.pdf

3.     It was compiled by a committee of 22 implant dentists in Singapore. They referred to 121 respected papers from all over the world. These guidelines are endorsed by the Academy of Medicine Singapore, Ministry of Health, Society of Periodontology, College of Dental Surgeons, Association of Oral and Maxillofacial Surgeons and Prosthodontic Society of Singapore. Dated August 2012.

On page 19 is the recommendation for narrow diameter dental implants for mandibular overdenture retention. Although there is no comment on the use of minis or narrow diameters for crowns and bridges, there is no disapproval either. It usually means that the jury is out and practitioners should use them responsibly as they see fit.

If you go to the link immediately below, there is posted one of the most comprehensive debates on the use of minimized dental implants for lower full denture stabilization:-

RESORBED MANDIBLE BEST TREATMENT PLAN DEBATE

http://www.osseonews.com/resorbed-mandible-case-best-treatment-plan/

LOWER FULL DENTURE STABILIZATION

ANOTHER

AND ANOTHER

LOWER AND UPPER FULL DENTURE STABILIZATION

LET US BRING THESE SIMPLE AND AFFORDABLE TREATMENT

TO EVERYONE WHO NEEDS THEM 

THROUGHOUT THE WORLD!!!